Pacemakers and other implantable medical devices (IMDs) are becoming increasingly common. A conventional IMD is a battery-powered device that applies electrical impulses to a patient's heart to rectify arrhythmias. Typically, one or more electrodes are attached to the heart and coupled to the IMD via conductive leads. The electrodes and leads allow detection of electrical activity and also enables the delivery of electrical stimulus to the heart as appropriate.
As medical and computing technologies have progressed, IMDs have become increasingly capable of applying highly sophisticated and elaborate therapies, including pacing of multiple chambers of the heart. Such therapies can often be uniquely tailored to the particular needs of the patient, provided that adequate information about the patient is available while the device is being implanted and/or configured. The current state of the art is such that the techniques used for acutely identifying potential responders to cardiac therapy, at the time that the device is implanted in the patient, need substantial improvement.
In particular, the impact of atrial or ventricular lead placement can be difficult to evaluate while the device is being implanted. Early passive fixation leads typically required that leads be placed in specific regions of the ventricles in order to assure lead stability and long term performance. The advent of active fixation leads and left ventricular leads for cardiac resynchronization therapy now allows lead placement regions of the atria and ventricle that previously were not practical. Recent medical literature has described potential advantages of alternate site pacing lead placements in both the atrium and ventricles, including suppression of atrial and ventricular tachyarrhythmias, and improved symptoms of congestive heart failure. Despite this increased lead placement utility, however, few techniques are presently available to discriminate the relative advantage of various pacing lead sites.
It is therefore desirable to create a system and/or technique that is capable of identifying therapy responders during device implantation so that such information can be used to improve the effectiveness of applied therapy. Moreover, it is desirable to create a technique for optimizing lead placement or other parameters using hemodynamic information obtained at the time of implant. Furthermore, other desirable features and characteristics will become apparent from the subsequent detailed description and the appended claims, taken in conjunction with the accompanying drawings and this background section.